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Bifosfonatların Pediatrik Nefrolojide Kullanımı Pediatride Bifosfonatlar

Use of Biphosphonates in Pediatric Nephrology Biphosphonates in Pediatric

Journal Name:

Publication Year:

DOI: 
10.5262/tndt.2011.1002.03

Keywords (Original Language):

Abstract (2. Language): 
Biphosphonates (BP), synthetic analogues of inorganic pyrophosphate, potently inhibit skeletal resorption by suppressing the recruitment and activity of osteoclasts and shortening their life span and decreasing bone loss. They are now well established as the major drugs used for the treatment of bone disease associated with excessive resorption such as Paget’s disease, metastatic bone disease and osteoporosis, and refractory hypercalcemia in adults. Over the past decade, BP use in patients with various forms of kidney disease has become widespread. Increasingly, BP are being administered to children and have been reported to improve clinical outcomes and augment bone mass in conditions such as osteogenesis imperfecta, juvenile osteoporosis and fibrous dysplasia. There have been few clinical trials in children to treat bone loss, such as in glucocorticoid-induced osteoporosis and renal osteodystrophy, resulting from renal disease or rheumatologic conditions. The aim of this review was to evaluate the currently available evidence for the effectiveness and safety of BP in children with renal and rheumatological diseases.
Abstract (Original Language): 
Bifosfonatlar (BP) sentetik pirofosfat analoğu bileşiklerdir. Kemik yapımı sırasında osteoklast baskılanmasına yol açarak onların sayı ve işlevlerini azaltır, yaşam süresini kısaltır ve kemik rezorpsiyonunu önlerler. Erişkinlerde aşırı kemik rezorpsiyonuyla giden Paget hastalığı, metastatik kemik hastalığı, osteoporoz ve dirençli hiperkalsemi tedavisindeki etkileri iyi bilinmektedir. Son yıllarda kronik böbrek hastalıkları ve romatolojik hastalıklarda kullanımı yaygınlaşmıştır. Bifosfonatların pediatride kullanımı osteogenesis imperfekta, juvenil osteoporoz, fibröz displazi gibi kemik rezorpsiyonuyla seyreden hastalıklarda başlamış, klinik bulguları düzelttiği ve kemik kitlesini arttırdığı bildirilmiştir. Çocuklarda kronik böbrek hastalıklarında ve romatolojik hastalıklarda, özellikle glukokortikoid kullanımına bağlı osteoporoz tedavisinde yararlı olduğunu gösteren az sayıda çalışma vardır. Bu derleme ile çocukluk çağı böbrek hastalıklarında BP’ların kullanımı ile ilgili veriler incelenmiş, kullanım alanları, etkinliği ve yan etkileri değerlendirilmiştir.
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